RETRACTED ARTICLE: Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis
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Guo et al. / J Zhejiang Univ-Sci B (Biomed & Biotechnol) 2019 20(3):238-252
Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) ISSN 1673-1581 (Print); ISSN 1862-1783 (Online) www.jzus.zju.edu.cn; www.springerlink.com E-mail: [email protected]
Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis*# Le-qian GUO1, Yu CHEN2, Bai-bing MI1, Shao-nong DANG1, Dou-dou ZHAO1, Rong LIU1, Hong-li WANG1, Hong YAN†‡1 1
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China 2
Medical Records Department, the First Hospital of Yulin, Yulin 718000, China †
E-mail: [email protected]
Received Mar. 7, 2018; Revision accepted Aug. 10, 2018; Crosschecked Jan. 10, 2019
Abstract: Several reviews have assessed the relationship between exposure to ambient air pollution and adverse birth outcomes during pregnancy, but the results remain controversial. The objective of this study was to assess this correlation quantitatively and to explore sources of heterogeneity. We included all published case-control or cohort studies that evaluated the correlation between ambient air pollution and low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Analytical methods and inclusion criteria were provided on the PROSPERO website (CRD42018085816). We evaluated pooled effects and heterogeneity. Subgroup analyses (grouped by exposure period, study settings, study design, exposure types, data source, Newcastle-Ottawa quality score (NOS), and adjustment for smoking or meteorological factors) were also conducted and publication bias was examined. The risk of bias in systematic reviews (ROBIS) tool was used to evaluate the overall risk of bias in this review. Forty studies met the inclusion criteria. We observed pooled odds ratios (ORs) of 1.03–1.21 for LBW and 0.97–1.06 for PTB when mothers were exposed to CO, NO2, NOx, O3, PM2.5, PM10, or SO2 throughout their pregnancy. For SGA, the pooled estimate was 1.02 in relation to NO2 concentrations. Subgroup analysis and sensitivity analysis decreased the het2 erogeneity to some extent, such as the subgroups of continuous measures (OR=0.98 (0.97–0.99), I =0.0%) and 2 NOS>7 (OR=0.98 (0.97–0.99), I =0.0%) in evaluating the association between PTB and NO2. This review was completed with a low risk of bias. High concentrations of air pollution were significantly related to the higher risk of adverse birth outcomes. However, the sources of heterogeneity among studies should be further explored. Key words: Air pollution; Low birth weight; Preterm birth; Meta-analysis; Adverse birth outcome https://doi.org/10.1631/jzus.B1800122 CLC number: R173
1 Introduction
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Corresponding author Project supported by the National Natural Science Foundation of China (No. 81230016) and the Birth Defect Control and Prevention Project of Shaanxi Commission of Health and Family Planning (No. sxwsjs wzfcght2016-013), China # Electronic supplementary materials: The onlin
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